Dora Jackson RMT

04/30/2026

Why does manual therapy work? An increasing amount of evidence points to systemic rather than local effects. Why does it matter? We need to keep it real so as not to perpetuate myth and reliably replicate results.

Why does manual therapy work?

It’s a question most of us have been asked — by patients, by students, sometimes by ourselves mid-treatment.

A 2025 living review in PLOS ONE (Keter et al.) pulled together 62 systematic, narrative, and scoping reviews to map the current evidence.

Manual therapy doesn’t act on one system. It produces measurable responses across the following:

- Neurological
- Neurovascular
- Neurotransmitter,
- Neuroimmune
- Neuromuscular
- Neuroendocrine
- Biomechanical

The strongest, most consistent signals are central, not local: increased pressure pain thresholds at sites distant from treatment and enhanced descending pain modulation.

The biomechanical “joint-out-of-place” model? It's not supported by the evidence. The treatments purporting to do this may help, but for the reasons above, not because the joint has been popped back in.

What this means in practice: our hands are interacting with the central nervous system at least as much as the tissue beneath them and the language we use with patients should reflect that.

The full one-page clinical summary is below 👇

📖 Source: Keter et al. (2025), PLOS ONE. doi:10.1371/journal.pone.0319586

04/24/2026

Pain is complex but there are a few simple concepts at it’s core that everyone should know and understand.

Pain does not always mean damage.
Threat increases pain and safety reduces it.
Pain is always real.

02/05/2026

01/15/2026

How does massage therapy (or any manual therapy) work? When I was in school many moons ago, we looked at the mechanisms through a very narrow, and largely inaccurate, lens. We now have enough knowledge to appreciate that the answer is much more complex but not quite enough to answer the question confidently. Still, it’s a good start.

https://sites.duke.edu/cemmt/2026/01/13/what-really-happens-when-we-use-manual-therapy-a-fresh-look-at-the-mechanisms-behind-hands-on-approaches/?fbclid=IwdGRleAPUeV1leHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEeBZ2sI3ujJLf0T1ia4ugZ2dLfIo3h_HUXJxiSUuC4kpAX8CLxBVlGeWneueg_aem_PYkqHKpAH7pXIEjpPnKeVQ

Home » Blog » What Really Happens When We Use Manual Therapy? A Fresh Look at the Mechanisms Behind Hands-On Approaches

11/15/2025

Myth: running is bad for your knees

“Running ruins your knees”…..🏃‍♀️🏃🏻

You’ve heard it. Your fellow runners, family/friends have heard it. Your non-running colleague definitely believes it.

But here’s what the research actually says 👇

Does running cause knee arthritis?

Short answer: No.
Long answer: It may actually reduce it.

A large systematic review & meta-analysis published in JOSPT (2017) looked at thousands of runners. The findings?

👉 Recreational runners had lower rates of hip and knee osteoarthritis than people who didn’t run.
👉 Competitive high-volume elite runners showed slightly higher risk, but recreational runners—99% of the population—were protected.

Why?
Running improves cartilage nutrition, strengthens bone, boosts muscle capacity, and supports healthy body weight. Joints like movement. They hate inactivity.

Bottom line:
If you’re running for health, longevity, and enjoyment, you’re doing more good for your knees than harm.

Share this to help bust an old, outdated myth.

10/24/2025

Common myths in massage therapy

RMTs in Ontario are trained, regulated, and part of your healthcare team. Massage therapy can help people manage pain, increase their function and improve their overall quality of life. This article dispels some massage therapy myths that persist.

Learn more about some common debunked myths about massage therapy: https://www.rmtao.com/resources/rmtao-blog/massage-therapy-myths-and-facts

09/27/2025

“One size fits all” has never really worked. All generalizations are doomed to inaccuracy and ineffectiveness at least some of the time and any measure of success is likely due to luck. Research that targets specific populations can only help us find better solutions to pain and disease.

For decades, the assumption has lingered that women must tolerate pain better than men. After all, women experience childbirth, menstrual cramps, and other painful conditions throughout their lives. But research tells a different story — one that has profound implications for how we understand and treat pain.

Stanford’s Dr. Sean Mackey has been at the forefront of challenging these myths. “These studies are sending us a clear message that s*x differences aren’t just stronger or weaker — they’re often entirely different wiring diagrams,” he explains in a recent Washington Post article. “And we need to be mindful of these differences between men and women when we’re treating them.”

Those differences are more than theoretical. Scientists now know that everything from brain circuitry to immune pathways to pain-sensing neurons can function differently depending on s*x. These biological distinctions explain why certain conditions — like migraine, fibromyalgia, and irritable bowel syndrome — disproportionately affect women, and why treatments may succeed in one group but not the other.

Take migraine drugs that block CGRP, for example. They were initially tested in male rodents, leading researchers to believe the therapy wasn’t effective. When the studies were expanded to include females, the opposite was revealed: the drugs had little effect in men but transformed care for many women. Without s*x-specific research, that breakthrough might never have reached patients.

For Mackey, the lesson is clear: progress in pain medicine depends on listening to patients, respecting their differences, and designing studies and treatments that reflect the diversity of human biology. And while he is known for advancing the science, his message to people living with chronic pain is just as direct: “Don’t suffer in silence, and don’t give up. There is help out there.”

07/29/2025

We need to stop thinking of osteoarthritis (OA) as just a “wear-and-tear” disease. The science now tells a more nuanced story—one where metabolic dysfunction plays a central role. Not the only role. But an important one.

We need to stop thinking of osteoarthritis (OA) as just a “wear-and-tear” disease. The science now tells a more nuanced story—one where metabolic dysfunction plays a central role. Not the only role. But an important one.

Yes, obesity increases joint load, particularly in weight-bearing joints such as the knees. In fact, for every 5-point increase in BMI, the risk of knee OA rises by 35%. But the connection doesn’t stop there.

Hand osteoarthritis is also significantly more common in individuals with obesity. The hands don’t bear weight—so clearly, something more than load is at play.

That “something” is a constellation of metabolic abnormalities:

-Chronic hyperglycemia
-Insulin resistance
-Dyslipidemia
-Hypertension
-Systemic inflammation

These factors fuel joint degeneration from within. Elevated glucose levels stimulate the production of proinflammatory cytokines and matrix metalloproteinases (MMPs), which damage cartilage and degrade joint tissue. Insulin resistance and visceral fat contribute to chronic, low-grade inflammation, which in turn alters joint biology.

The same metabolic dysfunction that damages blood vessels, nerves, and organs also erodes joint integrity.

So no, osteoarthritis is not just a mechanical disease. It’s a metabolic one too.

The implications?
Managing OA means addressing load and biology. That includes: – Reducing visceral adiposity – Improving insulin sensitivity – Controlling inflammation – Engaging in strength training and aerobic movement – Prioritizing sleep and stress management.

OA is not always inevitable. It’s often modifiable. However, only if we understand what is driving it.